Abstract：
The global impact of coronavirus disease 2019 (COVID-19) marked by numerous pandemic peaks is attributed to its high variability and infectious nature, transforming it into a persistent global public health concern. With hundreds of millions of cases reported globally, the illness is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite its initial classification as an acute respiratory illness, recent evidence indicates that lingering effects on various bodily systems, such as cardiovascular, pulmonary, nervous, gastrointestinal (GI), and musculoskeletal, may endure well beyond the acute phase. These persistent manifestations following COVID-19, commonly known as long COVID, have the potential to affect individuals across the entire range of illness severity, with a tendency to be more prevalent in mild to moderate cases. At present, there are no established criteria for diagnosing long COVID. Nonetheless, it is conceptualized as a multi-organ disorder encompassing a diverse array of clinical manifestations. The most common, persistent, and debilitating symptoms of long COVID may be neurological, known as neurological complications of post-acute sequelae of COVID-19 (NC-PASC). More than one-third of individuals with a prior SARS-CoV-2 infection show involvement of both the central nervous system (CNS) and peripheral nervous system (PNS), as evidenced by an approximately threefold higher incidence of neurological symptoms in observational studies. The persistent neurological symptoms of long COVID encompass fatigue, headache, cognitive decline, \"brain fog\", dysautonomia, neuropsychiatric issues, loss of smell (anosmia), loss of taste (ageusia), and peripheral nerve problems (peripheral neuropathy). Reported pathogenic mechanisms encompass viral persistence and neuro-invasion by SARS-CoV-2, neuroinflammation, autoimmunity, coagulopathy, and endotheliopathy. Raising awareness of potential complications is crucial for preventing and alleviating the long-term effects of long COVID and enhancing the prognosis for affected patients. This review explores the hypothetical pathophysiological mechanisms and pathways of NC-PASC with a sole aim to increase awareness about this crippling disease.
摘要：
2019年冠状病毒病(COVID-19)的全球影响以众多大流行高峰为标志，归因于其高变异性和传染性。将其转变为持续存在的全球公共卫生问题。全球报告了数以亿计的病例，该疾病是由严重急性呼吸道综合症冠状病毒2（SARS-CoV-2）引起的。尽管它最初被归类为急性呼吸道疾病，最近的证据表明，对各种身体系统的挥之不去的影响，比如心血管，肺,紧张,胃肠（GI），和骨骼肌肉，可能会远远超过急性期。这些持续的表现在COVID-19之后，通常被称为长COVID，有可能影响整个疾病严重程度的个体，在轻度至中度病例中更普遍。目前,没有既定的诊断标准。尽管如此，它被概念化为多器官疾病，包括各种临床表现。最常见的,持久性,长COVID的衰弱症状可能是神经系统的，称为COVID-19急性后遗症（NC-PASC）的神经系统并发症。超过三分之一的既往有SARS-CoV-2感染的个体表现出中枢神经系统（CNS）和周围神经系统（PNS）的受累。在观察性研究中，神经系统症状的发生率大约高出三倍。长期COVID的持续神经系统症状包括疲劳，头痛,认知能力下降,“脑雾”，自主神经失调,神经精神问题,嗅觉丧失（嗅觉丧失），味觉丧失（迷幻），和周围神经问题（周围神经病变）。报道的致病机制包括病毒持续存在和SARS-CoV-2，神经炎症，自身免疫,凝血病,和内皮病。提高对潜在并发症的认识对于预防和减轻长期COVID的长期影响以及改善患病患者的预后至关重要。这篇综述探讨了NC-PASC的假设病理生理机制和途径，其唯一目的是提高对这种严重疾病的认识。
